NEW YORK — The aisles of American supermarkets can be
bewildering places these days, lined with dozens of variations of cereals,
crackers, chips and other foods, many of which boast of their supposed
healthfulness — this yogurt is "low fat," while this cereal is
"heart healthy," and those chips have "0 grams trans fat."
What claims are the conscientious eater to trust and what foods should they
pick to put on their table?

This question has become harder and harder for shoppers to
answer, as health problems associated with poor diets, such as heart disease
and obesity, affect more U.S. residents each year. Meanwhile, studies show that
Americans want more and better guidance on what
foods to eat.

"The public is demonstrably confused about what to eat,"
said Marion Nestle, a nutritionist at New York University, who recently gave a
talk here at the New York Academy of Sciences about diet and food politics.

The rising
obesity epidemic in the United States (more than 30 percent of U.S. adults
are now obese), combined with the proliferation of various labeling
schemes and the worries about the potentially misleading nature of some of
these schemes, has prompted the U.S. Food and Drug Administration to conduct a
review of so-called front-of-package labeling. The aim is to come up with a
standard set of regulations that would govern what claims manufacturers can
make on these food labels.

"We had noticed a real proliferation of these
front-of-package symbols, and noticed that there were a lot of different
ones," said Siobhan DeLancey, an FDA spokesperson. "And there didn't
seem to be any rule of thumb or real consistency for consumers to be able to
depend on."

The FDA and nutrition advocates hope the review will remedy
this situation and provide consumers with a standard system of labels they can
rely on to make choices about what foods they buy.

"The FDA is taking a good, hard look at the entire
front-of-package situation," Nestle said.

Labels, labels
everywhere

Claims like "low fat" and "high in
fiber" didn't begin to show up much on the fronts of food packages until
around 1994, when the Nutrition Facts panel was required for every food package,
under the provisions of the 1990 Nutrition Labeling and Education Act.

"Until then, the FDA said that health claims were drug
claims and food companies had to do what drug companies have to: prove safety
and effectiveness," Nestle told LiveScience.

But manufacturers argued that since they were required to
put potentially negative nutrition information on their foods (for example, the
number of calories or grams of fat), they should also be allowed to point out their
product's positives. Congress agreed and told the FDA to allow health claims
that were backed up by a reasonable amount of science, Nestle said. After that,
front-of-package claims exploded.

"There are health claims on everything," Nestle
said.

DeLancey said criteria must be met for foods to bear claims
such as "high in fiber" or "low in salt" — fiber in the
food must be above a certain amount and salt below a certain amount. But when
such claims appear on many breakfast cereals and snack foods that may also be
high in sugar or calories, the result can be consumer confusion and consumption
of foods that aren't actually healthy, Nestle said.

"Most people get their nutrition
information from food marketers, and that information is not exactly
unbiased," Nestle said.

Studies seem to at least partly back up this worry. The
FDA's 2008 Health and Diet Survey — a random phone survey of more than 2,500
adults from all 50 states and the District of Columbia — looked at how
Americans use and view front-of-package labels. It found that more than half
read food labels when they first pick up a package — up 10 percent from 2001.

For claims such as "low fat," "high
fiber," and "cholesterol-free," 38 percent of respondents said
they often used such claims, while 34 percent said they did sometimes. The
survey found that 41 percent of respondents trust that all or most of the
nutrient claims such as "low fat" or "high fiber" are
accurate, while 56 percent believe that some or none of them are accurate,
pointing to confusion on the part of consumers over what labels they can trust.

An online survey of 1,045 adults by FoodMinds — a food and
nutrition company — found U.S. consumers seem to want the government to help clear
up the confusion. Their survey, conducted in January this year, found that 86
percent of respondents were interested in the government implementing objective
front-of-package labeling that highlights calories and beneficial nutrients in
a food. And 77 percent were interested in labels that would warn them when a
food was high calorie and low in nutrients; 64 percent said they would eat less
of or stop buying a food that had such a warning.

Smart choices

The situation reached something of a head when in September
of last year, The New York Times wrote an article about the Smart
Choices program — a voluntary labeling program used by several companies in
collaboration — and how the label that was supposed to indicate foods that were
healthy choices ended up appearing on a box of Fruit Loops, among other
less-than-healthy options.

The attention brought to labeling by this and other
articles, complaints from consumers and advocates, and the sheer number of
labeling schemes being used prompted the FDA to send out warning letters to
some manufacturers in October 2009 asking them to review their own labels for
accuracy. The FDA also notified the companies the FDA would begin its own
review of such schemes. (Smart Choices was voluntarily suspended in October
pending the FDA review.)

"We didn't ask anybody to take them off the market, but
we said, 'Look, you need to do a review of these and ensure that they're really
accurate,'" DeLancey said.

Review in progress

The FDA is currently in the middle of the review process,
which involves both looking at existing and proposed labeling schemes for
accuracy, and conducting surveys of consumers to find out what they want from
such schemes.

The key, DeLancey told LiveScience, is to find out
"what consumers are going to find the most useful and that's actually
going to give them accurate information."

Various labeling schemes have been used and proposed: Some list
just a couple key points of nutrition, such as calories, accompanied by a check
mark or other symbol; some are a truncated version of the Nutrition Facts label
that show key points, such as calories, fat, sugar and sodium; others include
on top of that information a "traffic light" symbol (something that
has been used with success in the United Kingdom) by each nutrient that
indicates whether that nutrient is in the acceptable range (green) or not
(red).

The U.S. Institute of Medicine (IOM) is reviewing some of
these schemes and any studies that have been done on food labels to see how
accurate and informative they are. The IOM committee acts as an impartial,
non-government source that regularly advises on the scientific issues involved
in such matters. The IOM is slated to complete their report later this year.

Working with consumers is also important because the FDA
wants to make sure that any schemes they pick or regulations they set will
result in a system that consumers will actually use, that they can use for
quick reference and will give them accurate information.

"We're looking at ways to give them the information in
a more easily digestible" format, DeLancey said.

DeLancey noted a phenomenon called the "truncation
effect" as one consideration in any scheme: Customers might be in a hurry
to get dinner on the table or have kids they're trying to keep an eye on, and
"that keeps people from turning around and looking at the Nutrition Facts
label." So the easier-to-use and more accurate any scheme is, the more
likely it is to result in a shopper picking a healthy food option.

DeLancey says that the FDA has talked with industries as
well, "and they are actually pretty supportive."

The final word on
food labels

The consumer studies the FDA is conducting are slated to
finish at the end of this year or the beginning of next. The next step will be
to use the information from these and the IOM report to come up with a draft
set of regulations to govern front-of-package labeling, to be published in the
Federal Register, and then open that draft up to a period of public comment.
Once any "substantive" comments (those that make legitimate
suggestions and critiques) have been addressed, the FDA can adopt the
regulation.

Whether the end result will be a specific labeling scheme or
a set of regulations over just what can or must be on the front of a package
isn't yet decided.

"We haven't decided yet whether there's going to be one
universal symbol, because we may find that there are certain products that need
a different kind of symbol, like beverages versus traditional food,"
DeLancey said. "But there will be one set of criteria for using it."

Ultimately, no matter what kind of labeling system or
regulations are set up, the burden of picking a better diet rests with the
individual consumer.

"Nobody can regulate what people actually eat, you can
only give them the information, the accurate information to make their own
choices," DeLancey said.

If you ask Nestle, she doesn't like any food labeling
schemes, noting that junk food is junk food, no matter what nutrients might be
added to it. Her tips for a healthier diet are: "Eat
less; move more; eat fruits and
veggies; don't eat too much junk food; enjoy."

Andrea Thompson

Andrea graduated from Georgia Tech with a B.S. in Earth and Atmospheric Sciences in 2004 and a Master's in the same subject in 2006. She attended the Science, Health and Environmental Reporting Program at New York University and graduated with a Master of Arts in 2006.